According to the complaint, Remicade enjoyed monopoly status from 1998 until the entry of Pfizer’s biosimilar, Inflectra (infliximab-dyyb), in 2016 [1] and Merck’s biosimilar, Renflexis (infliximab-abda), in 2017 [2]. This monopoly, according to Walgreen and Kroger, allowed J&J to sell Remicade at extremely high prices and to generate annual US sales of about US$4.8 billion in 2016.

Walgreen and Kroger claim that J&J used exclusionary contracts, bundled discounts and coercive rebates to insurers to maintain a monopoly. This they say suppressed competition from the infliximab biosimilars and meant that they only managed to gain a minimal (‘de minimis’) share (< 5%) of the infliximab market. ‘Absent that exclusionary conduct, those products would have achieved much higher market shares and plaintiffs and other purchasers would have received the benefits of that price competition in the form of lower purchase prices’ the lawsuit claims.

J&J implemented what it described as its ‘Biosimilar Readiness Plan’ within weeks of the approval of Pfizer’s infliximab biosimilar in 2016 [3]. According to the lawsuit this was done to maintain J&J’s market share. The plan included entering into deals with health insurers under which they agreed to exclude infliximab biosimilars from coverage altogether, or to only cover them if treatment with Remicade failed.

These actions have also affected the majority of patients in the US say the two pharmacy chains. They claim that ‘J&J has induced most of the major health insurers in the US, covering at least 70% of privately insured patients in the US, to adopt these exclusionary restrictions’.

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References
1. GaBI Online - Generics and Biosimilars Initiative. FDA approves infliximab biosimilar Inflectra [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Jul 13]. Available from: www.gabionline.net/Biosimilars/News/FDA-approves-infliximab-biosimilar-Inflectra
2. GaBI Online - Generics and Biosimilars Initiative. FDA approves biosimilar infliximab Renflexis [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Jul 13]. Available from: www.gabionline.net/Biosimilars/News/FDA-approves-biosimilar-infliximab-Renflexis
3. GaBI Online - Generics and Biosimilars Initiative. Antitrust activities in the pharmaceutical industry [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Jul 13]. Available from: www.gabionline.net/Generics/Research/Antitrust-activities-in-the-pharmaceutical-industry

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